Bottom Line:
Skin texture showed better response than other variables with average score of 2.44.No long-term adverse effects were noted in any patient.Lack of a control group and small sample size are limitations of this study.

Background: Fractional photothermolysis is one of the most effective treatment options used to resurface scars of different aetiologies.

Aim: To assess the efficacy and safety of fractional CO2 laser resurfacing treatment in the management of non-hypertrophic traumatic and burn scars.

Materials and methods: Twenty-five patients affected by non-hypertrophic traumatic and burn scars were treated with four sessions of fractional CO2 laser resurfacing treatment at 6-weekly intervals. Patients were photographed at each visit and finally, 3 months after the end of treatment schedule. Response to treatment was assessed clinically as well as by comparing the initial photograph of the patient with the one taken at the last follow-up visit 3-months after the final treatment session. Changes in skin texture, surface irregularity and pigmentation were assessed on a quartile grading scale and scored individually from 0 to 4. A mean of the three individual scores was calculated and the response was labelled as 'excellent' if the mean score achieved was >2. A score of 1-2 was labeled as good response while a score below 1 was labeled as 'poor' response. The subjective satisfaction of each patient with the treatment offered was also assessed at the last follow-up visit.

Results: The commonest site of scarring treated was the face followed by hands. Response to treatment was rated as excellent in 60% (15/25) patients while 24% (6/25) and 16% (4/25) patients were labeled as good and poor responders, respectively. Skin texture showed better response than other variables with average score of 2.44. Linear post-traumatic scars were seen to respond less than other morphological types. Majority of the patients (19 out of 25) were highly satisfied with the treatment offered. No long-term adverse effects were noted in any patient.

Mentions:
Physician-based assessment included three variables of skin texture, distortion and pigmentation of the scars. We noticed improvement in all of these variables but skin texture improved the most after fractional laser resurfacing. Improvement in skin texture was appreciated by a soft and more uniform appearance as well as feel of the scarred skin [Figure 4 and b]. Skin texture was also the first to show an appreciable response with patients as well as investigators noticing improvement even after the initial session of laser resurfacing [Figure 5a and b]. Pigmentation over the scars also improved gradually and this also contributed to the change in overall appearance of the scar. However, totally depigmented scars did not show any repigmentation with fractional laser resurfacing and needed additional treatment modalities like skin grafting to take care of this abnormality.

Mentions:
Physician-based assessment included three variables of skin texture, distortion and pigmentation of the scars. We noticed improvement in all of these variables but skin texture improved the most after fractional laser resurfacing. Improvement in skin texture was appreciated by a soft and more uniform appearance as well as feel of the scarred skin [Figure 4 and b]. Skin texture was also the first to show an appreciable response with patients as well as investigators noticing improvement even after the initial session of laser resurfacing [Figure 5a and b]. Pigmentation over the scars also improved gradually and this also contributed to the change in overall appearance of the scar. However, totally depigmented scars did not show any repigmentation with fractional laser resurfacing and needed additional treatment modalities like skin grafting to take care of this abnormality.

Bottom Line:
Skin texture showed better response than other variables with average score of 2.44.No long-term adverse effects were noted in any patient.Lack of a control group and small sample size are limitations of this study.

Background: Fractional photothermolysis is one of the most effective treatment options used to resurface scars of different aetiologies.

Aim: To assess the efficacy and safety of fractional CO2 laser resurfacing treatment in the management of non-hypertrophic traumatic and burn scars.

Materials and methods: Twenty-five patients affected by non-hypertrophic traumatic and burn scars were treated with four sessions of fractional CO2 laser resurfacing treatment at 6-weekly intervals. Patients were photographed at each visit and finally, 3 months after the end of treatment schedule. Response to treatment was assessed clinically as well as by comparing the initial photograph of the patient with the one taken at the last follow-up visit 3-months after the final treatment session. Changes in skin texture, surface irregularity and pigmentation were assessed on a quartile grading scale and scored individually from 0 to 4. A mean of the three individual scores was calculated and the response was labelled as 'excellent' if the mean score achieved was >2. A score of 1-2 was labeled as good response while a score below 1 was labeled as 'poor' response. The subjective satisfaction of each patient with the treatment offered was also assessed at the last follow-up visit.

Results: The commonest site of scarring treated was the face followed by hands. Response to treatment was rated as excellent in 60% (15/25) patients while 24% (6/25) and 16% (4/25) patients were labeled as good and poor responders, respectively. Skin texture showed better response than other variables with average score of 2.44. Linear post-traumatic scars were seen to respond less than other morphological types. Majority of the patients (19 out of 25) were highly satisfied with the treatment offered. No long-term adverse effects were noted in any patient.